Maize distribution: people receive 25 kg, which is supposed to last two weeks. Salala Resettlement Area.

Field Exchange interviewed Maura O'Donahue the health and nutrition advisor for CAFOD's Emergency Support Section (ESS) in the Headquarter offices in London. Maura is a doctor and Medical Missionary of Mary. She started her overseas work in Africa specialising in public and community health. Her involvement with CAFOD began during the 1984 Ethiopian famine when CAFOD supported famine relief work in which she was involved. She then worked in Addis Ababa for the Ethiopian Catholic Secretariat between 1984 and 1987. She subsequently set up an HIV/AIDS desk within CAFOD which became the lead agency for this type of work for CARITAS International. After nine years and a short period in New York she moved back into emergency work taking up the health and nutrition advisor post in 2000.

Maura explained how CAFOD was formed in the 1960s when the Catholic Women's League responded to a hurricane in the Caribbean. After this the Bishop's conference for England and Wales created CAFOD as the national CARITAS for the UK and Wales. CAFOD's mandate dictates that it work in both relief and development and works through implementing partners. Although most IPs are church based, CAFOD does occasionally work through noncatholic or non-faith based partners. For example, Islamic Relief have recently been an important partner in Ingushettia. CAFOD receives its funding through voluntary income raised through parishes, schools and religious communities, and through institutional donors like DfID and ECHO.

The emergency support section was only set up in the last 5 years. The section has a Strategic Framework with a set of goals, objectives and indicators for monitoring achievements. There is also an emergency handbook which sets out principles, procedures and guidelines for emergency responses. For example, there is a set of questions that have been designed to determine at what level CAFOD should respond when considering an emergency. If CAFOD is considering a corporate response then the curiously named 'Bubbling Emergency Group' is convened to reach decisions and take forward the response. ESS support to partners can take a variety of forms such as making joint assessments in the initial stages of an emergency, providing specific technical inputs, working together to set standards and develop indicators with which to monitor and review the impact of the work and undertaking capacity building particularly in protracted emergencies.

The ESS are involved in a range of emergency sectors including food and nutrition activities. CAFOD does not purchase or shift food. They supply funds to local partners to purchase food and depend on partners to identify the best type of response in a food emergency. CAFOD supports a range of food and nutrition activities including general rations, supplementary feeding, food for work and cash for work, seeds and tools programmes and agricultural rehabilitation. CAFOD also devotes a lot of resources to providing technical support for their partners who may have steep learning curves to go through. As Maura explained 'in some situations CAFOD have to provide a lot of training'. At the same time Maura was at pains to point out that working through local church-based organisations can have enormous benefits. 'Local church structures have pretty good outreach into a community and can find out what is going on at grass-roots level'. 'People also have a lot of confidence in their local parish, for example, In Tigray CAFOD have been supporting local church organisations in responding to recurrent drought for many years.'More recently local churches have been questioning why things appear not to improve. This has led to activities like reducing soil erosion through terracing, reclaiming gullies and promoting horticulture. Maura believes that without the infrastructure of the church and local trust in it, this type of longer-term activity would not have been possible.

The grass-roots nature of faith-based organisations can also improve access to information for advocacy purposes. Maura gave an example from the Somali region of Ethiopia where it was relatively easy to get information on the fact that the general rations being received were far less than the amounts that humanitarian agencies were claiming.

In support of the idea that church based agencies offer comparative advantages, Maura cited a recent experience in Marsabit, Kenya where UNICEF have been capacity building with local church organisations and increasingly using them as implementing partners in situations of drought. As part justification for the UNICEF programme the Nairobi based representative recently stated that ' when others leave church-based groups will still be there'.

I asked Maura what were the things that she came across in the course of her work that currently worried her the most. She had a number of concerns, for example:

'Emergency supplementary feeding programmes often ended up supplementing nothing' (because general ration programmes were not being adequately implemented).

'NGOs only manage to get resources for intervention when there is evidence of acute malnutrition when what is needed is a preventive response' (CAFOD recently supported an 'early' intervention in Binga and Bulawayo in Zimbabwe which was a form of livelihood support programme).

The micronutrient content of general rations is not given enough consideration (she cited IDP camps in Ingushettia as an example where anaemia was rife).

Lack of availability of measles vaccines (she recently came across this in Iraq).

Lack of time for proper lesson learning in CAFOD supported programmes.

Lack of provision of non-food aid items for refugees and IDPs.

I also asked Maura what were the high and low points that stood out for her in a long and distinguished career. High points for her were when local partners took a longer-term approach to problems, e.g. local partners addressing chronic problems in Tigray. Low points included those all too frequent situations when the general ration failed to reach the 2100 kcal benchmark and people's nutritional status started to deteriorate. Maura also referred again to the IDP camps in Ingushettia where tents that had an eight month shelf-life were still being used after four years and were being patched up by any means available; and sanitation in the camps had reached the appalling state of there being only one toilet per 120 people. Maura finished our interview with the statement that she would like to see more imaginative food and nutrition interventions. I asked for examples. She in turn asked me if I had heard of the Moringa tree. I had to confess that I hadn't, at which point I thought I noticed the slightest of disappointments. Maura went on to explain that the tree, which is indigenous to many parts of central and east Africa, Asia and central and Latin America, has many nutritional benefits. It has more calcium and protein than milk, it has a high percentage of oil, more potassium than bananas and more vitamin A than carrots. It also has certain medicinal properties and although as yet scientifically unproven may have a water purification potential. It's leaves, flowers and pods are all edible and (according to Maura) if powdered leaf is added to porridge malnourished children have shown greater weight gains than with special foods used in selective feeding programmes. Some CAFOD partners have already started growing the trees in nurseries although the potential of this tree is virtually unknown amongst INGOs.

In parting Maura warned me that she was going back into the field in a couple of days and so would not be able to check the draft of this agency profile. With country responsibilities that include, Ethiopia, Tigray, Zimbabwe, Kenya, Ingushettia, Chechnya, India and the Philippines, I realised that I was lucky to have grabbed an hour with such a busy person and someone whose unstinting commitment, drive and work-load were a shining example for many of us.